In the 70th year of the NHS, the arguments have never raged more fiercely over policy.

But amidst all the over-arching debates about coping with more frail elderly citizens, and finding the means to properly align social care and health budgets and priorities, are the inevitable questions over local provision.

It goes without saying that if a poll were ever conducted about the ideal personal scenario, everyone would vote for a hospital at the end of their road, and a GP practice open all hours. But back on planet reality, there are much harder choices to be made.

The current fears over the future of the Vale of Leven Hospital are not without justification. We have watched the salami-slicing of services from there over the last few years, and each time, it emerges more slimline than ever in terms of what it provides to the local population.

But the latest row over the proposal to centralise breast services, I would argue, is more nuanced than some of the others.

It’s very true that it’s more complicated to access services in Paisley, especially if you’re using public transport. But it’s also the case that some of the required breast services are not a medical emergency. There is time to plan the journey.

There are other practical considerations. Centralised services in various disciplines do make it easier to attract specialist staff.

And where centres of excellence are created or grow, there are invariably better outcomes for patients.

A classic case is stroke victims; time is obviously of the essence, but so too is the presence of the equipment and the expertise to offer the best treatment.

Similarly, any cases which are liable to require brain surgery are now routinely fast-tracked to the QEUH in Govan where anyone with a serious head injury has the best possible chance of repair and recovery. And the Golden Jubilee in Clydebank is now a regional and national resource for heart and lung patients.

I don’t think these particular developments had a hidden agenda of depriving local people of adequate services on their doorstep.

Rather they were an acknowledgement that every local hospital can’t do everything, and some services do benefit us by being centralised.

So I’m not without long standing suspicions about the overall direction of travel at the Vale of Leven over the last few years. But I tend to think the breast services plan has more plusses than minuses.